title: Quality assurance in head and neck surgical oncology: EORTC 24954 trial on larynx preservation.
abstract: BACKGROUND
  The Head and Neck Cancer Group (HNCG) of the EORTC conducted a quality assurance program in the EORTC 24954 trial on larynx preservation. In this multicentre study, patients with resectable advanced squamous cell carcinoma of the larynx or hypopharynx were randomly assigned for treatment with sequential or alternating chemoradiation. The need for a quality assurance program is the evaluation and prevention of differences in treatments between centres in this multidisciplinary study.
  
  
  METHODS
  The surgical subcommittee of the HNCG prepared a questionnaire, and clinical records of all patients were verified during audits of independent teams. Data relating institutional practices were collected during a face to face interview with members of the local team.
  
  
  RESULTS
  271 clinical records from the nine main contributing centres were reviewed. The main difference between centres was the time interval between first consultation and treatment initiation, with a mean of 45 days. On the pathology report the nodal involvement was described by level in 36% of the cases according to the American Academy of Otolaryngology-Head and Neck Surgery classification. Extranodal spread was not always described in neck dissection specimens.
  
  
  CONCLUSIONS
  The EORTC 24954 trial on larynx preservation was the first prospective trial with a quality assurance program in head and neck surgical oncology. The analysis shows similarities in practices, but also points out some important differences between centres. Operation reports were fairly complete, but uniformity in pathology reports should be improved.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: cr.leemans@vumc.nl.
authors.forename: C R
authors.initials: CR
authors.lastname: Leemans
authors.forename: B M
authors.initials: BM
authors.lastname: Tijink
authors.forename: J A
authors.initials: JA
authors.lastname: Langendijk
authors.forename: G
authors.initials: G
authors.lastname: Andry
authors.forename: M
authors.initials: M
authors.lastname: Hamoir
authors.forename: J L
authors.initials: JL
authors.lastname: Lefebvre
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant / Q000592:standards*; D003131:Combined Modality Therapy; D005060:Europe; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy; D008485:Medical Audit; D015337:Multicenter Studies as Topic / Q000592:standards; D059351:Organ Sparing Treatments / Q000592:standards; D010036:Otolaryngology / Q000592:standards; D010340:Pathology, Surgical / Q000592:standards; D010611:Pharyngectomy; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic / Q000592:standards*; D012074:Remission Induction
keywords: Head and neck surgical oncology; Larynx preservation; Quality assurance